Health
What to do in those first few days after an accident

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Schlachter- Pursuit Physiotherapy
So you hit a deer, or a car hit you, or you slid into a pole. You may have whiplash. This article is for those people who have been seen in the ER and sent home with a diagnosis of whiplash, or feel that aren’t hurt bad enough to warrant an Emergency Room visit. If you are at all concerned about your symptoms, please see your doctor. This article is speaking about the muscle and soft tissue injuries that can occur with whiplash. These are some tips you can use immediately after the injury.
It is best you see a physiotherapist for treatment, but these are some things to
start with until your appointment.
During a collision, your head is moved suddenly on your neck. The muscles, ligaments, and soft tissues in your neck are not prepared for these sudden movements, and can get overstretched, or strained and sprained. Like all acute injuries there will be inflammation and pain, and a risk of re-injury for the first 3-10 days. So for these early days, you might have to modify your job task or hours, rest your neck, avoid lifting, avoid leaning over where your neck muscles have to support your head-your head and brain weigh approximately 11 pounds. This first time frame is all about resting your neck ligaments and muscles.
Resting your neck for the first few days is very helpful to healing. I suggest after you have been up and about-possibly to work, or doing home chores, to lie flat on your back with ice under your neck for 10 minutes. This means usually with one pillow only-you shouldn’t feel “propped up on pillows”. That position actually pushes your head and neck forward-more overstretching. Just a reminder that our body doesn’t stay strong if we rest too much, so keep this limited to the first few days.
There are often things we do that we don’t realize can cause strain to your neck.
- Carrying anything over about 7 lbs will cause strain to the neck muscles. Choose carefully what you carry, and whatever you do have to carry, use 2 hands and keep it close to your chest. If you carry bags in one hand for example, that bag is pulling down on those muscles that have been already overstretched.
- Be aware of how you are sitting both at work, and while driving. During both activities we are concentrating, and often leaning forward. You might have to adjust your seat to have more back support, and head support.
- After a shower, wearing a damp towel on your wet hair adds weight to your head that your neck muscles aren’t up to supporting. Or vigorously shaking your head to style and dry your hair is too aggressive for the neck.
- Changing the laundry can be a challenge for the neck-either pulling wet, heavy jeans out of a washer, to looking into that front loading washer to make sure you got all the socks. You may have to ask for help with these tasks or make the loads smaller or get right down on your hands and knees to look into the washer.
- Unsupported leaning forward or prolonged looking down makes the neck muscles work hard to hold your head up. Tasks that require this are bathing children in the tub, doing dishes, wiping muddy dog feet, reaching down into the freezer. Frequently our leisure activities have us looking down for long periods, such as texting and playing games on our devices, reading, sewing, doing puzzles.
- In Alberta climates, there is snow in the winter. Those first couple of weeks, I would suggest getting help pushing the grocery cart through the snowy parking lot-when we feel good, we don’t realise the effort moving one of those carts takes and it’s especially worse after a fresh snowfall. Also asking for help with shovelling is a good idea-lots of leaning forward looking down, and lifting with shovelling.
So make sure in those first few days after an accident you rest your neck, and make an appointment to see a physiotherapist. Our staff at Pursuit Physiotherapy would be happy to help you get back to your normal function, strength, and comfort level.
Posted by Leanne Schlachter
Pursuit Physiotherapy in Red Deer, promotes balanced, healthy living through dedicated, individualized physical therapy for those in pain, unable to participate fully in their daily activities, wanting to maximize their function for work or sport, and wanting to prevent potential problems.
If it is affecting your quality of life, then we want to help you to optimize your function and minimize your pain.
We are committed to your health and want to encourage you to be too.
Addictions
Why B.C.’s new witnessed dosing guidelines are built to fail

Photo by Acceptable at English Wikipedia, ‘Two 1 mg pills of Hydromorphone, prescribed to me after surgery.’ [Licensed under CC BY-SA 3.0, via Wikimedia Commons]
By Alexandra Keeler
B.C. released new witnessed dosing guidelines for safer supply opioids. Experts say they are vague, loose and toothless
This February, B.C pledged to reintroduce witnessed dosing to its controversial safer supply program.
Safer supply programs provide prescription opioids to people who use drugs. Witnessed dosing requires patients to consume those prescribed opioids under the supervision of a health-care professional, rather than taking their drugs offsite.
The province said it was reintroducing witnessed dosing to “prevent the diversion of prescribed opioids and hold bad actors accountable.”
But experts are saying the government’s interim guidelines, released April 29, are fundamentally flawed.
“These guidelines — just as any guidelines for safer supply — do not align with addiction medicine best practices, period,” said Dr. Leonara Regenstreif, a primary care physician specializing in substance use disorders. Regenstreif is a founding member of Addiction Medicine Canada, an advocacy group that represents 23 addiction specialists.
Addiction physician Dr. Michael Lester, who is also a founding member of the group, goes further.
“Tweaking a treatment protocol that should not have been implemented in the first place without prior adequate study is not much of an advancement,” he said.
Witnessed dosing
Initially, B.C.’s safer supply program was generally administered through witnessed dosing. But in 2020, to facilitate access amidst pandemic restrictions, the province moved to “take-home dosing,” allowing patients to take their prescription opioids offsite.
After pandemic restrictions were lifted, the province did not initially return to witnessed dosing. Rather, it did so only recently, after a bombshell government report alleged more than 60 B.C. pharmacies were boosting sales by encouraging patients to fill unnecessary opioid prescriptions. This incentivized patients to sell their medications on the black market.
B.C.’s interim guidelines, developed by the BC Centre on Substance Use at the government’s request, now require all new safer supply patients to begin with witnessed dosing.
But for existing patients, the guidelines say prescribers have discretion to determine whether to require witnessed dosing. The guidelines define an existing patient as someone who was dispensed prescription opioids within the past 30 days.
The guidelines say exemptions to witnessed dosing are permitted under “extraordinary circumstances,” where witnessed dosing could destabilize the patient or where a prescriber uses “best clinical judgment” and determines diversion risk is “very low.”
Holes
Clinicians say the guidelines are deliberately vague.
Regenstreif described them as “wordy, deliberately confusing.” They enable prescribers to carry on as before, she says.
Lester agrees. Prescribers would be in compliance with these guidelines even if “none of their patients are transferred to witnessed dosing,” he said.
In his view, the guidelines will fail to meet their goal of curbing diversion.
And without witnessed dosing, diversion is nearly impossible to detect. “A patient can take one dose a day and sell seven — and this would be impossible to detect through urine testing,” Lester said.
He also says the guidelines do not remove the incentive for patients to sell their drugs to others. He cites estimates from Addiction Medicine Canada that clients can earn up to $20,000 annually by selling part of their prescribed supply.
“[Prescribed safer supply] can function as a form of basic income — except that the community is being flooded with addictive and dangerous opioids,” Lester said.
Regenstreif warns that patients who had been diverting may now receive unnecessarily high doses. “Now you’re going to give people a high dose of opioids who don’t take opioids,” she said.
She also says the guidelines leave out important details on adjusting doses for patients who do shift from take-home to witnessed dosing.
“If a doctor followed [the guidelines] to the word, and the patient followed it to the word, the patient would go into withdrawal,” she said.
The guidelines assume patients will swallow their pills under supervision, but many crush and inject them instead, Regenstreif says. Because swallowing is less potent, a higher dose may be needed.
“None of that is accounted for in this document,” she said.
Survival strategy
Some harm reduction advocates oppose a return to witnessed dosing, saying it will deter people from accessing a regulated drug supply.
Some also view diversion as a life-saving practice.
Diversion is “a harm reduction practice rooted in mutual aid,” says a 2022 document developed by the National Safer Supply Community of Practice, a group of clinicians and harm reduction advocates.
The group supports take-home dosing as part of a broader strategy to improve access to safer supply medications. In their document, they say barriers to accessing safer supply programs necessitate diversion among people who use drugs — and that the benefits of diversion outweigh the risks.
However, the risks — and harms — of diversion are mounting.
People can quickly develop a tolerance to “safer” opioids and then transition to more dangerous substances. Some B.C. teenagers have said the prescription opioid Dilaudid was a stepping stone to them using fentanyl. In some cases, diversion of these drugs has led to fatal overdoses.
More recently, a Nanaimo man was sentenced to prison for running a highly organized drug operation that trafficked diverted safer supply opioids. He exchanged fentanyl and other illicit drugs for prescription pills obtained from participants in B.C.’s safer supply program.
Recovery
Lester, of Addiction Medicine Canada, believes clinical discretion has gone too far. He says take-home dosing should be eliminated.
“Best practices in addiction medicine assume physicians prescribing is based on sound and thorough research, and ensuring that their prescribing does not cause harm to the broader community, as well as the patient,” he said.
“[Safer supply] for opioids fails in both these regards.”
He also says safer supply should only be offered as a short-term bridge to patients being started on proven treatments like buprenorphine or methadone, which help reduce drug cravings and manage withdrawal symptoms.
B.C.’s witnessed dosing guidelines say prescribers can discuss such treatment options with patients. However, the guidelines remain neutral on whether safer supply is intended as a transitional step toward longer-term treatment.
Regenstreif says this neutrality undermines care.
“[M]ost patients I’ve seen with opioid use disorder don’t want to have [this disorder],” she said. “They would rather be able to set goals and do other things.”
Oversight gaps
Currently, about 3,900 people in B.C. participate in the safer supply program — down from 5,200 in March 2023.
The B.C. government has not provided data on how many have been transitioned to witnessed dosing. Investigative journalist Rob Shaw recently reported that these data do not exist.
“The government … confirmed recently they don’t have any mechanism to track which ‘safe supply’ participants are witnessed and which [are] not,” said Elenore Sturko, a Conservative MLA for Surrey-Cloverdale, who has been a vocal critic of safer supply.
“Without a public report and accountability there can be no confidence.”
The BC Centre on Substance Use, which developed the interim guidelines, says it does not oversee policy decisions or data tracking. It referred Canadian Affairs’ questions to B.C.’s Ministry of Health, which has yet to clarify whether it will track and publish transition data. The ministry did not respond to requests for comment by deadline.
B.C. has also not indicated when or whether it will release final guidelines.
Regenstreif says the flawed guidelines mean many people may be misinformed, discouraged or unsupported when trying to reduce their drug use and recover.
“We’re not listening to people with lived experience of recovery,” she said.
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
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Addictions
‘Over and over until they die’: Drug crisis pushes first responders to the brink

First responders say it is not overdoses that leave them feeling burned out—it is the endless cycle of calls they cannot meaningfully resolve
The soap bottle just missed his head.
Standing in the doorway of a cluttered Halifax apartment, Derek, a primary care paramedic, watched it smash against the wall.
Derek was there because the woman who threw it had called 911 again — she did so nearly every day. She said she had chest pain. But when she saw the green patch on his uniform, she erupted. Green meant he could not give her what she wanted: fentanyl.
She screamed at him to call “the red tags” — advanced care paramedics authorized to administer opioids. With none available, Derek declared the scene unsafe and left. Later that night, she called again. This time, a red-patched unit was available. She got her dose.
Derek says he was not angry at the woman, but at the system that left her trapped in addiction — and him powerless to help.
First responders across Canada say it is not overdoses that leave them feeling burned out — it is the endless cycle of calls they cannot meaningfully resolve. Understaffed, overburdened and dispatched into crises they are not equipped to fix, many feel morally and emotionally drained.
“We’re sending our first responders to try and manage what should otherwise be dealt with at structural and systemic levels,” said Nicholas Carleton, a University of Regina researcher who studies the mental health of public safety personnel.
Canadian Affairs agreed to use pseudonyms for the two frontline workers referenced in this story. Canadian Affairs also spoke with nine other first responders who agreed to speak only on background. All of these sources cited concerns about workplace retaliation for speaking out.
Moral injury
Canada’s opioid crisis is pushing frontline workers such as paramedics to the brink.
A 2024 study of 350 Quebec paramedics shows one in three have seriously considered suicide. Globally, ambulance workers have among the highest suicide rates of public service personnel.
Between 2017 and 2024, Canadian paramedics responded to nearly 240,000 suspected opioid overdoses. More than 50,000 of those were fatal.
Yet many paramedics say overdose calls are not the hardest part of the job.
“When they do come up, they’re pretty easy calls,” said Derek. Naloxone, a drug that reverses overdoses, is readily available. “I can actually fix the problem,” he said. “[It’s a] bit of instant gratification, honestly.”
What drains him are the calls they cannot fix: mental health crises, child neglect and abuse, homelessness.
“The ER has a [cardiac catheterization] lab that can do surgery in minutes to fix a heart attack. But there’s nowhere I can bring the mental health patients.
“So they call. And they call. And they call.”
Thomas, a primary care paramedic in Eastern Ontario, echoes that frustration.
“The ER isn’t a good place to treat addiction,” he said. “They need intensive, long-term psychological inpatient treatment and a healthy environment and support system — first responders cannot offer that.”
That powerlessness erodes trust. Paramedics say patients with addictions often become aggressive, or stop seeking help altogether.
“We have a terrible relationship with the people in our community struggling with addiction,” Thomas said. “They know they will sit in an ER bed for a few hours while being in withdrawals and then be discharged with a waitlist or no follow-up.”
Carleton, of the University of Regina, says that reviving people repeatedly without improvement decreases morale.
“You’re resuscitating someone time and time again,” said Carleton, who is also director of the Psychological Trauma and Stress Systems Lab, a federal unit dedicated to mental health research for public safety personnel. “That can lead to compassion fatigue … and moral injury.”
Katy Kamkar, a clinical psychologist focused on first responder mental health, says moral injury arises when workers are trapped in ethically impossible situations — saving a life while knowing that person will be back in the same state tomorrow.
“Burnout is … emotional exhaustion, depersonalization, and reduced personal accomplishment,” she said in an emailed statement. “High call volumes, lack of support or follow-up care for patients, and/or bureaucratic constraints … can increase the risk of reduced empathy, absenteeism and increased turnover.”
Kamkar says moral injury affects all branches of public safety, not just paramedics. Firefighters, who are often the first to arrive on the scene, face trauma from overdose deaths. Police report distress enforcing laws that criminalize suffering.
Understaffed and overburdened
Staffing shortages are another major stressor.
“First responders were amazing during the pandemic, but it also caused a lot of fatigue, and a lot of people left our business because of stress and violence,” said Marc-André Périard, vice president of the Paramedic Chiefs of Canada.
Nearly half of emergency medical services workers experience daily “Code Blacks,” where there are no ambulances available. Vacancy rates are climbing across emergency services. The federal government predicts paramedic shortages will persist over the coming decade, alongside moderate shortages of police and firefighters.
Unsafe work conditions are another concern. Responders enter chaotic scenes where bystanders — often fellow drug users — mistake them for police. Paramedics can face hostility from patients they just saved, says Périard.
“People are upset that they’ve been taken out of their high [when Naloxone is administered] and not realizing how close to dying they were,” he said.
Thomas says safety is undermined by vague, inconsistently enforced policies. And efforts to collect meaningful data can be hampered by a work culture that punishes reporting workplace dangers.
“If you report violence, it can come back to haunt you in performance reviews” he said.
Some hesitate to wait for police before entering volatile scenes, fearing delayed response times.
“[What] would help mitigate violence is to have management support their staff directly in … waiting for police before arriving at the scene, support paramedics in leaving an unsafe scene … and for police and the Crown to pursue cases of violence against health-care workers,” Thomas said.
“Right now, the onus is on us … [but once you enter], leaving a scene is considered patient abandonment,” he said.
Upstream solutions
Carleton says paramedics’ ability to refer patients to addiction and mental health referral networks varies widely based on their location. These networks rely on inconsistent local staffing, creating a patchwork system where people easily fall through the cracks.
“[Any] referral system butts up really quickly against the challenges our health-care system is facing,” he said. “Those infrastructures simply don’t exist at the size and scale that we need.”
Périard agrees. “There’s a lot of investment in safe injection sites, but not as much [resources] put into help[ing] these people deal with their addictions,” he said.
Until that changes, the cycle will continue.
On May 8, Alberta renewed a $1.5 million grant to support first responders’ mental health. Carleton welcomes the funding, but says it risks being futile without also addressing understaffing, excessive workloads and unsafe conditions.
“I applaud Alberta’s investment. But there need to be guardrails and protections in place, because some programs should be quickly dismissed as ineffective — but they aren’t always,” he said.
Carleton’s research found that fewer than 10 mental health programs marketed to Canadian governments — out of 300 in total — are backed up by evidence showing their effectiveness.
In his view, the answer is not complicated — but enormous.
“We’ve got to get way further upstream,” he said.
“We’re rapidly approaching more and more crisis-level challenges… with fewer and fewer [first responders], and we’re asking them to do more and more.”
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
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